Speech-language Intervention Research Articles

The promise of self-determination theory to study the therapist-client relationship in speech-language treatment

This study aims at examining the therapist-client relationship in speech-language treatment and its relationships with clients’ motivation from the perspective of Self-Determination Theory (SDT). It adds to the current literature by relying on observations as well as client perceptions of the therapists’ interaction style and by studying three different age groups of adults (>18 years old), adolescents (12−18 years old) as well as children (<12 years). Two convenience samples: 1) 42 Speech Language Therapists (SLPs; 95.2 % female) and 72 individuals with communication disorders (ICDs) (72.2 % female;>12 years old), and 2) 21 SLPs (100 % female) and 44 ICDs (50 % girls; <12 years) were recruited for this cross-sectional study. After engaging in a treatment session, ICDs responded to a set of validated questionnaires measuring the SLPs’ motivating style, their need-based experiences and motivation towards the treatment. Moreover, each treatment session was observed. Both client-reported as well as observational measures show that SLPs more strongly evince an autonomy-supportive (i.e. motivating) when compared to a controlling (i.e. demotivating) style to the benefit of their clients’ motivation. The display of empathy was the most frequently observed strategy. SLPs regularly provided rationales, choices, and opportunities for clients to experiment. However, these behaviors were more frequent in younger compared to older clients. With the younger clients, SLPs frequently used effort-contingent rewards, which is considered a controlling strategy in SDT. Results showed that motivational benefits may be expected if SLPs rely on an autonomy-supportive rather than a controlling style. This study provides a valuable starting point for an SDT-driven examination of the therapist-client relationship and ICD’s motivation in the context of speech-language pathology.

The Application of Lexical Retrieval Training in Tablet-Based Speech-Language Intervention.

In the setting of shortened hospitalization periods, periods of confinement and social isolation, limited resources, and accessibility, technology can be leveraged to enhance opportunities for rehabilitative care (1). In the current manuscript, we focus on the use of tablet-based rehabilitation for individuals with aphasia, a language disorder that frequently arises post-stroke. Aphasia treatment that targets naming through effortful and errorful instances of lexical retrieval, where corrective feedback is generated on every trial, may enhance retention and generalizability of gains (2, 3). This pilot evaluation explored how six individuals with aphasia interacted with a tablet-based therapy application that targeted lexical retrieval. Participants with aphasia either (1) autonomously engaged with the therapy tasks or (2) received systematic encouragement to effortfully retrieve words. Behaviors of response latency and cue use were examined to gain insights into the behavioral patterns of both groups, as well as analyses of task accuracy and outcomes on standardized cognitive–linguistic assessments. Despite some variability, initial observations suggest that participants who received systematic training refrained from using cues to complete tasks and spent longer on each trial, which ultimately co-occurred with increased independent engagement with therapy and improved standardized outcomes. Preliminary results present an alternative means of leveraging technology to implement best-practice recommendations in the context of aphasia telerehabilitation.

Modified script training for nonfluent/agrammatic primary progressive aphasia with significant hearing loss: A single-case experimental design

ABSTRACT Speech-language pathology caseloads often include individuals with hearing loss and a coexisting neurogenic communication disorder. However, specific treatment techniques and modifications designed to accommodate this population are understudied. Using a single-case experimental design, the current study investigated the utility of modified Video Implemented Script Training for Aphasia (VISTA) for an individual with nonfluent/agrammatic variant primary progressive aphasia and severe-to-profound, bilateral hearing loss. We analyzed the impact of this intervention, which incorporates orthographic input and rehearsal, on script production accuracy, speech intelligibility, grammatical complexity, mean length of utterance, and speech rate. Treatment resulted in comparable positive outcomes relative to a previous study evaluating script training in nonfluent/agrammatic primary progressive aphasia patients with functional hearing. Follow-up data obtained at three months, six months, and one year post-treatment confirmed maintenance of treatment effects for trained scripts. To our knowledge, this is the first study to investigate a modified speech-language intervention tailored to the needs of an individual with PPA and hearing loss, with findings confirming that simple treatment modifications may serve to broaden the range of treatment options available to those with concomitant sensory and communication impairments.

Competencias profesionales para el trabajo con población multilingüe y multicultural en España: creencias, prácticas y necesidades de los/las logopedas

Background and aimsThe increase in the number of people who require bilingual and multilingual speech-language intervention justifies reviewing the current practices of Speech-Language Therapists (SLTs), who are ethically responsible for providing the best possible evidence-based intervention to the families with whom they work. There is, therefore, a clear need to competently serve populations with linguistically and culturally diverse backgrounds. The goal of this work was to document the beliefs, needs and practices of SLTs in Spain, as well as to obtain a deeper understanding of linguistic, cultural and professional competencies from the perspective of SLTs. MethodBased on previous work in other countries, a questionnaire was designed to study multilingual and multicultural speech-language intervention in Spain. The sample consisted of 208 SLTs working with a diverse population across regions of Spain. ResultsEighty-four percent of the survey respondents reported that they speak more than one language, but only 56% considered themselves bilingual; 77% reported having faced the challenge of working with multilingual people; 86% reported that they had not received training focused on this diversity and 92% reported that they lacked resources for conducting bilingual speech and language evaluations. Nevertheless, there were significant differences in the beliefs and practices when bilingual and monolingual SLTs were compared. ConclusionsThis work, with results similar to those of previous studies, provides a first step for designing methods, policies and resources to improve professional competencies and multilingual practices. Several challenges for SLTs facing this new social reality are discussed.

Development of Neural Structure and Function in Autism Spectrum Disorder: Potential Implications for Learning Language.

Purpose Neurodevelopmental processes that begin during gestation and continue throughout childhood typically support language development. Understanding these processes can help us to understand the disruptions to language that occur in neurodevelopmental conditions, such as autism spectrum disorder (ASD). Method For this tutorial, we conducted a focused literature review on typical postnatal brain development and structural and functional magnetic resonance imaging, diffusion tensor imaging, magnetoencephalography, and electroencephalography studies of the neurodevelopmental differences that occur in ASD. We then integrated this knowledge with the literature on evidence-based speech-language intervention practices for autistic children. Results In ASD, structural differences include altered patterns of cortical growth and myelination. Functional differences occur at all brain levels, from lateralization of cortical functions to the rhythmic activations of single neurons. Neuronal oscillations, in particular, could help explain disrupted language development by elucidating the timing differences that contribute to altered functional connectivity, complex information processing, and speech parsing. Findings related to implicit statistical learning, explicit task learning, multisensory integration, and reinforcement in ASD are also discussed. Conclusions Consideration of the neural differences in autistic children provides additional scientific support for current recommended language intervention practices. Recommendations consistent with these neurological findings include the use of short, simple utterances; repetition of syntactic structures using varied vocabulary; pause time; visual supports; and individualized sensory modifications.

Posture and dysphonia associations in patients undergoing total thyroidectomy: stabilometric analysis.

The aim of this study is the analysis of postural changes of patients affected by vocal disorders post-thyroidectomy, in the absence of post-operative organ damage, through a stabilometry analysis, evaluating the effectiveness of a speech-language intensive treatment in phoniatric and postural quality recovery. 260 patients with vocal dysfunction after surgery without iatrogenic damage were enrolled. 130 patients were subject to post-surgical logopedic rehabilitative training (Group A); other 130 patients were not subject to any post-surgical treatment (Group B). For all patients, vocal and stabilometric parameters were evaluated before and after 2days and 1month from surgery. Vocal parameters evaluated were Voice Handicap Index-10, Maximum Phonation Time and objective evaluation of voice with Multidimensional Voice Program (MDVP). Stabilometric parameters evaluated were Sway area (mm2) and Sway velocity (mm/s) in firm surface and foam pad with eyes opened and closed. Regarding the stabilometric parameters, Group A obtained a statistically significant recovery of the correct posture statistically significant compared to Group B, after a month of speech therapy. Vocal parameters (VHI, MPT, MDVP) were statistically different between the two groups (p < 0.05), with a better improvement in Group A. Thanks to our study, we have shown that a logopedic rehabilitation therapy in patients with dysfunctional post-thyroidectomy dysphonia improves both the vocal and postural outcomes.

Navigating the “Passaggio” Between Voice Therapy and a Singing Lesson: Ethical Considerations for the Speech-Language Pathologist

Purpose The purpose of this article is to discuss factors that guide ethical decision making in determining what constitutes medically necessary voice therapy that involves or targets singing, which is distinct from a singing lesson. Method Different treatment tasks and scenarios are identified, and their rationales are compared with deference to precedent literature and relevant portions of the American Speech-Language-Hearing Association Code of Ethics. These materials are referenced in an effort to define the boundaries between voice therapy involving singing technique and a singing lesson. Results Suggestions regarding goal writing and documentation to highlight apparent boundaries are made. Conclusions In the care of injured voices, both precedent and ethical principles support speech-language pathology treatment that targets singing. However, it is incumbent upon the treating speech-language pathologist to determine when they are venturing into tasks that no longer serve a therapeutic purpose and to refer the patient for voice lessons as appropriate.

자폐스펙트럼 장애의 언어중재에 대한 증강현실의 응용

자폐 스펙트럼 장애(autism spectrum disorders; ASD)는 개인의 특이점과 비정상적 행동의 복잡한 특성이 있으며, 일반적으로 시각 자극에 대한 선호와 사회적 의사소통과 주의력에서 문제점을 보인다. 이러한 ASD에 대한 다양한 중재 중 증강현실 등의 새로운 기술이 소개되고 있으며 이러한 기술들은 유연성이 있고 매력적인 방식으로 의사소통장애 재활에 대한 요구를 해결할 수 있다. 이 논문의 목적은 언어재활사가 재활 환경에서 사용할 수 있는 도구로서 증강현실(augmented reality; AR)의 잠재적 사용성을 알아보는 것이다. 연구에 따르면 감정 인식, 어휘 학습, 기본적인 놀이기술 발달 등 ASD를 가진 개인의 언어 및 의사소통 기술을 향상하기 위한 AR의 여러 응용 사례가 소개되고 있다. AR 사용의 긍정적 결과에는 동기 부여, 주의 집중 및 새로운 학습 과제의 참여도 증가 등이 있다. AR의 이점에 대해 임상가에게 제공되는 권장 사항과 함께 새로운 기술사용에 대한 한계점에 대해서도 다루고자 한다. 임상 환경에서 사용할 수 있는 간단한 AR 기반 콘텐츠 제작 단계별 지침을 제공하며, 이러한 콘텐츠의 활용과 적용에 관한 선행 연구를 제시한다. AR은 ASD에 대한 흥미와 참여도를 높이기 위한 좋은 도구임을 알 수 있다. 실용적인 가이드를 통해서 이 도구를 더욱 쉽게 이용할 수 있으며 임상가와 재활에 참여하는 모두에게 활용될 수 있다.

Proposta de intervenção fonoaudiológica em projeto social: estudo preliminar

Introdução: Trata-se de estudo preliminar acerca da inserção da Fonoaudiologia em projeto assistencial, cujos objetivos foram realizar proposta de intervenção fonoaudiológica a partir do levantamento de demandas relacionadas à linguagem escrita e promover ações com vistas à estimulação da linguagem e da aprendizagem. Descrição: Participaram do estudo crianças e adolescentes em situação de vulnerabilidade social, com queixas de dificuldades de leitura e escrita encaminhados pela coordenação da instituição. Os participantes foram sondados acerca da leitura, escrita, memória e consciência fonológica, em seguida participaram de 15 intervenções de estimulação da consciência fonológica, memória e linguagem escrita. Após as intervenções, os participantes foram reavaliados a fim de se comparar, verificar, analisar e descrever os resultados obtidos. 22 escolares com desempenho abaixo do esperado participaram da sondagem e seis participaram das intervenções. A análise dos dados do grupo antes e após as estimulações não apresentou diferenças estatisticamente significantes. Considerações Finais: O projeto social proporciona atividades de esporte e lazer para o escolar no turno em que não se encontra na escola. Ao longo do estudo identificou-se dificuldade de adesão às intervenções e falta de motivação para frequentar os encontros de estimulação. Foi possível levantar as demandas fonoaudiológicas relacionadas à linguagem escrita e promover a estimulação de consciência fonológica dos participantes. É importante privilegiar a conscientização dos envolvidos acerca dos benefícios da participação nos grupos de estimulação.

Atuação fonoaudiológica em projeto social: estudo preliminar

Introdução: Pesquisas vêm demonstrando a importância dos primeiros anos de vida no desenvolvimento do cérebro. Quando a criança não apresenta o desenvolvimento de linguagem esperado, poderá ter prejuízo em aquisições. Desta forma, a identificação precoce de alterações evita consequências educacionais e sociais desfavoráveis. Objetivo: propor projeto de intervenção fonoaudiológica em instituição de acolhimento de crianças; levantar dados acerca da linguagem das crianças antes e depois da intervenção fonoaudiológica; possibilitar a superação de alterações da linguagem. Métodos: Observação das crianças, em sala de atividades coletivas, por meio do formulário de observação. Em seguida, foram selecionadas crianças com risco para alteração de linguagem e estas foram submetidas a avaliação por meio da Avaliação do Desenvolvimento da Linguagem (ADL) e Avaliação Fonológica da Criança (AFC). As crianças foram estimuladas durante 12 encontros semanais, em grupos, e depois foram reavaliadas. Os dados foram tabulados e analisados comparando-se as avaliações antes e depois da estimulação e relatando-se os dados obtidos pelos questionários respondidos pelas cuidadoras. Resultados: As quatro crianças - 3 meninos e 1 menina - que participaram do estudo tiveram melhora nas avaliações da linguagem após o período de estimulação, 3 modificaram o grau de gravidade do distúrbio de linguagem, e uma superou as alterações de linguagem - “desenvolvimento normal da linguagem” - após a reavaliação. Conclusão: Os relatos das cuidadoras e resultados das reavaliações demonstraram que as intervenções surtiram efeitos positivos e foram relevantes para as crianças, caracterizando uma boa proposta de intervenção coletiva fonoaudiológica.

Data Tie Speech-Language Treatment Outcomes to Dosage in Children With ASD

Data Tie Speech-Language Treatment Outcomes to Dosage in Children With ASD

A survey of speech-language pathology treatment for non-progressive dysarthria in Australia

AbstractAim:To identify management practices of Australian speech-language pathologists (SLPs) in the treatment of non-progressive dysarthria using a subsystem approach, and to explore SLPs’ consideration and implementation of the theoretical underpinnings of non-progressive dysarthria management.Method:A 39-item online survey was distributed to Australian SLPs, with 80 responses suitable for data analysis.Results:Practices of SLPs were variable for the management of the speech subsystems. The Lee Silverman Voice Treatment (LSVT®) was the most commonly used manualised treatment program, and was employed by 63.77% of respondents. Almost all SLPs (&gt;88%) provided strategies to improve functional communication. There was no clear preference for low tech alternative and augmentative communication (AAC) devices. Speech generating devices were the most commonly employed high tech device. Almost two-thirds of respondents used non-speech oral motor exercises (NSOMEs) in treatment. SLPs had varied frequencies and models of service delivery for intervention. SLPs valued interventions targeting the activity and participation domains of the ICF, however this was restricted by the treatment context and resources available. The majority of SLPs (92.06%) were aware of the principles of motor learning, however many were unsure regarding the specifics of implementation.Conclusion:There is a clear need for further research into the efficacy of treatment techniques to guide decision-making.

More Than Articulation

You have accessThe ASHA LeaderFirst Person on the Last Page1 Mar 2020More Than ArticulationA new SLP investigates what people who are deaf really want from their speech-language treatment sessions. Laura SankeyMA, CF-SLP Laura Sankey Google Scholar More articles by this author , MA, CF-SLP https://doi.org/10.1044/leader.FPLP.25032020.72 SectionsAboutPDF ToolsAdd to favorites ShareFacebookTwitterLinked In I am the child of two culturally Deaf adults, both the only deaf people in their families. Both grew up trying to fit into the hearing community around them, participating in many hours of aural/oral intervention with a speech-language pathologist. As a result, my father has what many would label “normal speech,” frequently mistaken as a hearing person. My mother, on the other hand, has less-precise speech. I grew up listening to my father receive praise from strangers for his “wonderful speech,” while my mother received looks of annoyance from those who could not easily understand her. Those strangers heard only a handful of words from my parents. They did not hear the story of how each achieved the speech articulation they have, or the story of how different speech-language treatment looked in the ’70s and ’80s when they were growing up. Throughout his childhood, my father’s speech-language intervention was an experience of frustration and pain, as his hair was pulled time and time again as punishment for not articulating sounds and words correctly. His stories and those of other, older members of the Deaf community made me wonder whether children today continue to have negative experiences. This question lingered as I worked toward my master’s degree in speech-language pathology, motivating me to conduct a qualitative research study. In graduate school, we learn the basics of communication: the development of phonemes and morphemes, how to administer standardized assessments, the importance of evidence-based practices. However, we have the potential to leave a far greater impact on our clients. After interviewing young Deaf adults, I began to understand their needs beyond articulation and structured language. These adults came from diverse backgrounds. Some used hearing aids, while others used cochlear implants. Some transferred to schools for the Deaf, while others remained in mainstream education until graduating high school. However, they shared an experience of intense aural/oral intervention, with years of trying to fit in to the hearing world around them. Listening to—or rather watching—these young adults share their experiences, it became clear that what they wanted most from their time with SLPs was not perfect speech. It was not strong aural skills. What they wanted most was to understand their identity as Deaf individuals, to find a community of peers and role models who shared their experiences, positive and negative. Their advice to clinicians who work with children who are deaf? Incorporate aspects of Deaf culture and the Deaf community into treatment sessions. Expose students to Deaf role models. I am completing my clinical fellowship at the Missouri School for the Deaf. I provide assessment and intervention services to students through a variety of communication modalities. With the voices of those young Deaf adults in mind, I take advantage of opportunities whenever possible to incorporate Deaf people and their work into my sessions. In doing so, I hope to show my students the beauty that lies in their language, their culture, and the community that surrounds them. Author Notes Laura Sankey, MA, CF-SLP, is a clinician at the Missouri School for the Deaf in Fulton. [email protected] Advertising Disclaimer | Advertise With Us Advertising Disclaimer | Advertise With Us Additional Resources FiguresSourcesRelatedDetails Volume 25Issue 2March 2020 Get Permissions Add to your Mendeley library History Published in print: Feb 28, 2020 Metrics Downloaded 1,758 times Topicsasha-topicsleader_do_tagleader-topicsasha-article-typesCopyright & Permissions© 2020 American Speech-Language-Hearing AssociationLoading ...

Contemporary Speech and Oral Language Care for Deaf and Hard-of-Hearing Children Using Hearing Devices.

Contemporary speech and language interventions are not limited to disabilities but embrace the pragmatics of communication behaviors from the perspective of functional social participation. Accordingly, current speech and language therapies for deaf and hard-of-hearing children include a broad spectrum of approaches and techniques. This paper explores contemporary approaches and techniques for speech and oral language interventions for deaf and hard-of-hearing children using hearing devices, evidence of efficacy and how they are implemented in diverse clinical practices.

Canine and Hearing Support Open Up an Audiology Career for a Student Who Is Deaf

You have accessThe ASHA LeaderFirst Person on the Last PageJanuary–February 2020Canine and Hearing Support Open Up an Audiology Career for a Student Who Is DeafWith a service dog and cochlear implants, a student born deaf tackles the rigors of an AuD program. Lauren Armstrong Lauren Armstrong Google Scholar More articles by this author https://doi.org/10.1044/leader.FPLP.25012020.72 SectionsAboutPDF ToolsAdd to favorites ShareFacebookTwitterLinked In As I sit here, an audiology graduate student who uses cochlear implants, I realize that life presents everybody with sets of different challenges that shape who you are today. I was born into a world of silence. I didn’t hear the sounds of the machines taking my vitals or my parents’ voices speaking loving words to me. Everything was silent, empty, and unknown, until a device was surgically implanted into my inner ear at the age of 2-1/2. Then my world filled with sounds, roaring noises, and beeps. To get to where I am today, I received speech-language intervention as a young girl at the University of Tennessee (UT)—inside Neyland Stadium, where the clinic was located—to learn to speak. I worked to overcome challenges as I tackled how to live in a hearing world with cochlear implants. For example, some people would deliberately cover their mouths or turn their back to me during conversations, and some professors refused to allow my accommodations, saying that I’m not intelligent enough to accomplish anything in life. I found solutions, experimenting with the programming of my cochlear implant and physically manipulating the device to meet my athletic needs. I participated in track, soccer, horseback riding, and dance, and I needed the implant to not fly off my ear. My dad and I put tubing around the bottom of my implant and sewed the tubing into my ear hook to keep it from sliding off from sweat. I was always interested in the programming changes made to my implant—the process itself and why a particular selection was made. And while attending mainstream schools as a kid, I was always interested in math and science. But audiology was not my first choice of field when I was deciding on my future: I originally wanted to become a physician’s assistant while I majored in neuroscience here at UT. Since becoming more accepting of myself and my hearing loss, I have been fully intrigued by the field and cannot get enough of it. I have always wanted to show people who are hard of hearing and deaf that they can achieve anything that they want, and that their hearing loss need not hold them back. I do this daily by advocating for myself and others when available accommodations fail to provide full access to communication, sharing the beautiful American Sign Language through my Painted Pansy Shop on Etsy, and bringing awareness to Canine Companions for Independence hearing service dogs. My service dog, Elroy, alerts me to sounds I can’t hear, even with my cochlear implants. I need him to be able to live independently, especially when I don’t have my implants on. He helps alert me to people calling my name or any other important sounds I might miss. My ultimate goal is to specialize in pediatrics and cochlear implants. I want to show every patient that they can do anything they want, and that hearing loss is not a barrier to success and does not define them. I am eager to see what the future holds as I dive deeper into the field that changed my life at such a young age. Author Notes Lauren Armstrong is a first-year student in the AuD program at the University of Tennessee Health Science Center. [email protected] Advertising Disclaimer | Advertise With Us Advertising Disclaimer | Advertise With Us Additional Resources FiguresSourcesRelatedDetails Volume 25Issue 1January–February 2020 Get Permissions Add to your Mendeley library History Published in print: Jan 1, 2020 Metrics Current downloads: 854 Topicsasha-topicsleader_do_tagasha-article-typesleader-topicsCopyright & Permissions© 2020 American Speech-Language-Hearing AssociationPDF downloadLoading ...

Augmentative and Alternative Communication on Autism Spectrum Disorder: Impacts on Communication.

To verify the effects of the Speech-Language Intervention with Augmentative and Alternative Communication (AAC) in communicative acts in children with Autism Spectrum Disorder (ASD). This is a longitudinal case-study design involving three subjects attended in a Speech-Language Pathology (SLP) Clinic School. Primary data were obtained from the observation of recorded videos of pre and post-intervention therapist assessment sessions with each child in play activities, while secondary data come from interviews with parents. The analysis was performed based on the Pragmatic Test of the Infant Language Test - ABFW, through observational recordings, aiming to identify and quantify the communicative acts. It was possible to observe a 51.47% increase in the production of communicative acts in the three research subjects. In addition, it was found that there was higher quality in the acts produced, using more present verbal components and decreased acts that had non-interpersonal functions, such as gestures and vocal acts. Thus, there was an evolution in the functional language of the subjects. The use of Augmentative and Alternative Communication in the SLP therapy clinic is promising and effective in promoting the development of communication skills of individuals with ASD.

University-School Partnership Fast-Tracks Speech-Language Intervention for Preschoolers

University-School Partnership Fast-Tracks Speech-Language Intervention for Preschoolers

A Review of the Application of Distributed Practice Principles to Naming Treatment in Aphasia.

It is uncontroversial in psychological research that different schedules of practice, which govern the distribution of practice over time, can promote radically different outcomes in terms of gains in performance and the durability of learning. In contrast, in speech-language treatment research, there is a critical need for well-controlled studies examining the impact of the distribution of treatment on efficacy (for reviews, see Cherney, 2012; Warren, Fey, & Yoder, 2007). In this paper, we enumerate key findings from psychological research on learning and memory regarding how different schedules of practice differentially confer durable learning. We review existing studies of aphasia treatment with a focus on naming impairment that have examined how the distribution of practice affects treatment efficacy. We close by discussing potential productive lines of research to elaborate the clinical applicability of distributed practice principles to language treatment.

Treatment for Word Retrieval in Semantic and Logopenic Variants of Primary Progressive Aphasia: Immediate and Long-Term Outcomes

Purpose Recent studies confirm the utility of speech-language intervention in primary progressive aphasia (PPA); however, long-term outcomes, ideal dosage parameters, and relative benefits of intervention across clinical variants warrant additional investigation. The purpose of this study was to determine whether naming treatment affords significant, lasting, and generalized improvement for individuals with semantic and logopenic PPA and whether dosage manipulations significantly affect treatment outcomes. Method Eighteen individuals with PPA (9 semantic and 9 logopenic variant) underwent lexical retrieval treatment designed to leverage spared cognitive-linguistic domains and develop self-cueing strategies to promote naming. One group (n = 10) underwent once-weekly treatment sessions, and the other group (n = 8) received the same treatment with 2 sessions per week and an additional "booster" treatment phase at 3 months post-treatment. Performance on trained and untrained targets/tasks was measured immediately after treatment and at 3, 6, and 12 months post-treatment. Results Outcomes from the full cohort of individuals with PPA showed significantly improved naming of trained items immediately post-treatment and at all follow-up assessments through 1 year. Generalized improvement on untrained items was significant up to 6 months post-treatment. The positive response to treatment was comparable regardless of session frequency or inclusion of a booster phase. Outcomes were comparable across PPA subtypes, as was maintenance of gains over the post-treatment period. Conclusion This study documents positive naming treatment outcomes for a group of individuals with PPA, demonstrating strong direct treatment effects, maintenance of gains up to 1 year post-treatment, and generalization to untrained items. Lexical retrieval treatment, in conjunction with daily home practice, had a strong positive effect that did not require more than 1 clinician-directed treatment session per week. Findings confirm that strategic training designed to capitalize on spared cognitive-linguistic abilities results in significant and lasting improvement, despite ongoing disease progression, in PPA.

How Young Children Learn Language and Speech.

Pediatric clinicians are on the front line for prevention of language and speech disorders. This review uses prevailing theories and recent data to justify strategies for prevention, screening and detection, diagnosis, and treatment of language and speech disorders. Primary prevention rests on theories that language learning is an interaction between the child's learning capacities and the language environment. Language learning occurs in a social context with active child engagement. Theories support parent education and public programs that increase children's exposure to child-directed speech. Early detection of delays requires knowledge of language milestones and recognition of high-risk indicators for disorders. Male sex, bilingual environments, birth order, and chronic otitis media are not adequate explanations for significant delays in language or speech. Current guidelines recommend both general and autism-specific screening. Environmental and genetic factors contribute to primary language and speech disorders. Secondary and tertiary prevention requires early identification of children with language and speech disorders. Disorders may be found in association with chromosomal, genetic, neurologic, and other health conditions. Systematic reviews find that speech-language therapy, alone or in conjunction with other developmental services, is effective for many disorders. Speech-language interventions alter the environment and stimulate children's targeted responding to improve their skills.